The Last Abortion Doctor

For thirty-six years, Warren Hern has been one of the few doctors in America to specialize in late abortions. George Tiller was another. And when Dr. Tiller was murdered that Sunday in church, Warren Hern became the only one left.

The young couple flew into Wichita bearing, in the lovely swell of the wife's belly, a burden of grief. They came from a religious tradition where large families are celebrated, and they wanted this baby, and it was very late in her pregnancy. But the doctors recommended abortion. They said that with her complications, there were only two men skilled enough to pull it off. One was George Tiller, a Wichita doctor who specialized in late abortions.

They arrived in Wichita on Sunday, May 31. As they drove to their hotel, a Holiday Inn just two blocks from the Reformation Lutheran Church, they saw television cameras. They wondered what was going on, a passing curiosity quickly forgotten.

But when they got to their room, the phone was ringing. Her father was on the line. "There was some doctor who was shot who does abortions," he said.

They turned on CNN. Dr. Tiller had just been killed, shot in the head as he passed out church leaflets. In their shock, they mixed up the clinic and the church: We were supposed to be there. What if it had happened while we were there? What if he couldn't complete the procedure?

After the first two doors of bulletproof glass, a sign warns that cell phones, cameras, and PDAs will be confiscated. You put your ID into a turning wheel that spins it to the receptionist. She studies it and hits the buzzer that opens the third bulletproof door. In the waiting room, a sad woman with a tight perm waits for her daughter. The receptionist lets you through a fourth bulletproof door and leads you down a green hall decorated with lovely pictures of nature, leaving you in a small room stocked with tissues and free condoms.

Twenty minutes later, the abortionist enters. He's a tall man in green surgical scrubs, remarkably vigorous at seventy, emphatic in speech and impatient in manner. He has a long face and no lips, which gives him a severe look. He apologizes for having very little time. This is the day he sees patients for the first of three visits, giving them the seaweed laminaria, which slowly dilates the cervix, and his normal caseload has been doubled by Dr. Tiller's patients — including two with catastrophic fetal abnormalities and a fifteen-year-old who was raped, all in the second trimester, all traumatized by the assassin who calls himself pro-life, a phrase he cannot utter without air quotes and contempt. They hate freedom, he says. He says it again. He warns you not to use anyone's name or you will put them at risk.

Walking out, he leaves the door open. You hear voices drifting down the hall: The worst picture of an abortion doctor ever. Is that Fox? Yes, Bill O'Reilly. Supposedly they were there to protect us. You see a nurse you cannot name leading a middle-aged Indian woman to an examining room. You'll need to undress completely from the waist down. You hear one of the receptionists you cannot name speaking in the carefully modulated voice the abortionist prescribed in his first book, Abortion Practice, a classic in the field: "Truax and Carkhuff have described empathy as the counselor's ability to be sufficiently involved to make full use of his/her own emotional experience and sufficiently detached to differentiate his/her own emotional experience from those of the other."

Steps come down the hall. I'm Dr. Hern. Where are you from? Lie down now. Put your hand on your chest.

The phone rings. Did you have an ultrasound? And they referred you here?

Yesterday, the man arrested for Tiller's murder warned that more killings were on the way. All last week, the antiabortion groups put out statements denouncing the murder and praising the result. One called the killer a hero. As a result, a squad of U. S. marshals rushed out here last week on orders from the attorney general. One of them paces the hall. The second receptionist you cannot name asks him, Did you see that guy out there smoking a cigarette?

Yeah, I saw him.

The first receptionist keeps talking. If you can fax us the amnio. We don't know, we'll have to wait to see what your body tells us. Do you want us to run your Amex now?

Another phone rings and the second receptionist answers. It's basically a three-day process. We require that you stay here in Colorado.

The voices begin to overlap. Are you on any medication? Have you had surgery in the last year? No, we don't have any genetics counselors to interpret that for you. We don't get a lot of protestors. It's a liberal and tolerant community. If that changes, we will contact you. No, you'll get up and get in your car and drive home. And Lisa, if you have a change of heart, please call us — our schedule is completely full and you'll be taking someone else's place.

After another silence, a soft voice gets softer: I also want you to know, we don't care what your reasons are. We're not going to judge you.

In the kitchen of the Boulder Abortion Clinic, the abortionist bolts down two microwave tamales. He talks fast and doesn't smile. It is my view that we are dealing with a fascist movement. It's a terrorist, violent terrorist movement, and they have a fascist ideology...

He goes on like that for some time. Long before the first doctor got shot back in 1993, he was warning that it would happen. He was getting hate mail and death threats way back in 1970, just for working in family planning. They started up again in 1973, two weeks after he helped start the first nonprofit abortion clinic in Boulder. I started sleeping with a rifle by my bed. I expected to get shot. In 1985, someone threw a brick through his window during a protest by the quote unquote Pro-Life Action League. He put up a sign that said THIS WINDOW WAS BROKEN BY THOSE WHO HATE FREEDOM. In 1988, somebody fired five bullets through his window. In 1995, the American Coalition of quote unquote Life Activists put out a hit list with his name (and Tiller's name) on it. The feds gave them protection for about six months, then left them on their own.

People don't get it, he says. After eight murders, seventeen attempted murders, 406 death threats, 179 assaults, and four kidnappings, people are still in denial. They say, Well, this was just some wingnut guy who just decided to go blow up somebody. Wrong. This was a cold-blooded, brutal, political assassination that is the logical consequence of thirty-five years of hate speech and incitement to violence by people from the highest levels of American society, including but in no way limited to George W. Bush, Ronald Reagan, Jesse Helms, Bill O'Reilly, Jerry Falwell, and Pat Robertson. Reagan may not have been a fascist, but he was a tool of the fascists. George W. Bush was most certainly a tool of the fascists. They use this issue to get power. They seem civilized but underneath you have this seething mass of angry, rabid anger and hatred of freedom that is really frightening, and they support people like the guy who shot George — they're all pretending to be upset, issuing statements about how much they deplore violence, but it's just bullshit. This is exactly what they wanted to happen.

He goes on about Bill O'Reilly for a while. Over the course of twenty-nine separate shows, O'Reilly accused "Tiller the Baby Killer" of performing a late abortion for any reason at all, even so a girl could attend a rock concert — a charge that is blatantly untrue. O'Reilly is a disgrace to American society, he says.

But O'Reilly says he's just exercising his right to engage in vigorous debate, you point out.

He's full of shit. This is not a debate, it's a civil war. And the other people are using bullets and bombs. I think O'Reilly is a fascist, and he would fit right in in Nazi Germany as far as I'm concerned.

It's odd, you say, trying to be agreeable. They always go after the doctors. They never go after the moms.

His eyes snap up. What moms? The patients?

Yeah, the patients.

They're not moms until they have a baby.

By the way, he hates the word abortionist. Though it is a simple descriptive term like "podiatrist," the opponents of abortion have turned it into a degrading and demeaning word that has the same negative connotations as the most despicable racial epithet. All the same, it is the right word, an accurate word, and our discomfort with it is but a measure of how poisoned the language of abortion has become.

Late that night, he calls you at your hotel. You're reading one of his many scientific publications, which have titles like Shipibo Polygyny and Patrilocality or Urban Malignancy: Similarity in the Fractal Dimensions of Urban Morphology and Malignant Neoplasms. This one argues that man is a "malignant ecotumor" laying waste the planet. One of the main characteristics of a cancerous growth is that it resists regulation. A cancer cell is a cell that reproduces without limits.

He's sorry, he says, but he must turn down your request to ride in his car to the Tiller memorial in Denver. He has to go with four U. S. marshals in an armored car. Even his wife can't ride with him. Same with dinner in a restaurant. I will never be safe, he says. I'm always looking over my shoulder.

You use the term "partial-birth abortion" and he bristles. It's a barbaric and grotesque term for a procedure that was described at National Abortion Federation meetings in the early nineties by two doctors who didn't take the deadliness of the psychological warfare seriously, and then the Republicans took it up and it became this obscene and basically pornographic antiabortion pornography with pictures that made it look like you were killing this beautiful Gerber baby — and when he tried to tell his colleagues, No, this is not the safest way to perform a delayed abortion, they accused him of working with the antiabortion people and basically rode him out on a rail. The whole thing turned into a tumultuous, writhing, tortured witch hunt — an incredibly painful experience.

Nothing pains him more than the disdain of other doctors. Sometimes the young ones ask to come in for an afternoon so they can learn to make a little money while their careers get started — they think it's as simple as changing a tire. There's no sense that this is an important operation that has to be done well, that a person's life depends on it. But let's face it, abortion is the lowest-status activity in medicine. That's why they always call their clinics Family Planning Centers or Women's Wellness Facilities or some crap like that. Not his place. It's had the same name since 1975. Because I felt that performing abortions was the most important thing I could do in medicine.

The patients can be upsetting too. They're under terrible stress, of course, but sometimes they come in very angry. One had conjoined twins and would have died giving birth, but she exploded when he told her she couldn't smoke in the office. And some treat him with contempt and disgust, usually the ones who have been directly involved in antiabortion activities. They hate all abortion except for their special case. One even said they should all be killed. Only fourteen, she came with her mother. What brings you here? he asked. I have to have an abortion. Why? I'm not old enough to have a baby. But you told the counselor we should all be killed? Yes, you should all be killed. Why? Because you do abortions. Me too? Yes, you should be killed too. Do you want me killed before or after I do your abortion? Before.

He told her to leave. Her mother was very upset. But he isn't an abortion-dispensing machine. He's a physician. He's a person.

The abortionist's mother is ninety-two, but she still has a girlish smile and twinkling eyes that summon gingham skirts and radio serials. When you come in, she's sitting in an easy chair surrounded by her family. You bend down to shake her grandson's hand.So you're the one who wants to be a pirate. He nods and adds in a shy voice: Or now maybe a doctor.

The phone rings and the abortionist goes to answer. He speaks in a heated voice. Hanging up, he's visibly agitated. That guy got your number off the Internet. He's a reporter.You have to change your number.

When he takes his family home, escorted by the U. S. marshals, she explains, almost apologetically, that her number hasn't been listed for almost forty years because the antiabortion people used to make nasty calls at two o'clock in the morning. Then there was a mix-up and it appeared in the phone book. Warren kept saying, You have to change your number, and I said, I don't want to change my number. I've had it all these years. Now she doesn't tell him about most of the calls. He's got enough to worry about.

As a boy? Always helpful. When he was just three, she'd give him a dust rag and let him dust. She'd set him on the counter and let him stir the cake. When he was ten, she and her husband, they went out one night and left the girls with a babysitter who spanked the oldest girl for refusing to go to sleep. When they got home, Warren said, Mother, I don't want you to hire anybody else to take care of Cindy. I can take care of her. So they never hired a babysitter again.

Warren sang in the choir. She felt it was important for the kids to go to church and Sunday school, and they didn't send them, they took them. They got involved in church activities. But politically, they were always on the liberal side. Warren likes to tell the story of how they cried when Roosevelt died. He was six, but he still remembers it.

He loved to go camping and fishing. He played clarinet in the Highlander Boys Band. He liked pranks — once he put an ad in the paper saying everybody could put their dead Christmas trees in a neighbor's yard.

His father was a carpenter, so they didn't have much money and couldn't afford to travel. But they always had exchange students from all over the world — Germany, Brazil, Italy, France, Pakistan, Japan, thirteen countries in all. That was a way the kids could learn how other people lived.

In fifth grade, Warren got interested in photography. Soon he was selling sports pictures to The Denver Post, staying up till midnight to develop the film, make prints, and rush them down to the paper. I probably saved every one of those pictures. He won second prize in Kodak's national contest for high school photography.

One thing that's probably important, she says: She had terrible migraines from as far back as she could remember. She'd get up in the morning and feel like her head was gonna roll down the hall. And one day she asked Warren what he wanted to be and he said, I really want to be a doctor, Mother. He thought he'd be a neuro brain surgeon and maybe he could figure out what to do about my headaches.

That same year, he read a book about Albert Schweitzer healing the sick in Africa and announced, Mother, I'm going to go to Africa before I go to medical school. And he did. He raised money from the Lions Club and the Rotary Club so he could be a community ambassador with the Experiment in International Living. She wasn't surprised. Usually when he says he's going to do it, he's going to find a way to do it.

At college, she says, he was the only white student in the African Club.

He worked three jobs to pay his tuition.

He began reading books like The Golden Bough, Man and His Gods, A Man Against Fate. He learned ancient Greek and studied the Bible in the original. Then he sat her down and said, Mom, I don't believe in this stuff anymore. She said, Well, you don't have to believe in it. Maybe I don't believe in all of it either. But she wasn't worried. She knew his heart.

In his last year of college, he went to a fundamentalist church to see an anticommunist movie called Operation Abolition. He came home and told his parents quite a story. You want to hear the Word of the Lord, you've got to pay! And I don't mean that jigglin' money, I mean that foldin' money! In an article he wrote for the school paper, he compared it to the "Two-Minute Hate" in George Orwell's 1984.

In medical school, he saw his first botched abortions. Then he spent two years as a doctor for the Peace Corps in a Brazilian town so desperately poor, it wasn't unusual to see a dead baby on a trash heap. After that, he worked as a family-planning chief for the Nixon administration and spent some time in Appalachia, where he saw unintended pregnancies dragging families deeper and deeper into poverty. In an article for The New Republic, he quoted one exhausted mother: Each one makes it harder on the ones we already got.

But even after all that, there are still some family members who can't accept what he does. And other doctors too. It really hurts him terribly, she says. In his mind, he's trying to help women who desperately need help. And why can't these doctors, of all people —

In her opinion, he needs to retire. He has a dozen books he wants to write. And this just takes his life.

The shooting? He called her as soon as it happened. He said, Jeanne just told me that George was shot in church. He said MSNBC wanted to interview him, told her what time to watch, trying to stay calm, but she could tell how upset he really was. It was all he could do to keep from losing it. I could hear the terror in his voice.

Well, you know, the people that really know Warren could see it, I'm sure. But not that many people probably.

You're a parent yourself, so you have to ask if she ever tried to get him to stop. Especially now that he's kind of making himself a target.

I know that, she answers. I understand that. But that wouldn't do any good. He's got a mind of his own.

The rims of her eyes are getting red. She moves her glasses and dabs at them with a balled-up tissue. You apologize for making her cry.

It's okay. It's all right.

Then she tries to be cheerful again, for the sake of her guest.

The next morning, you're just sitting down to breakfast when the phone rings. It's the abortionist's mother. She's been calling hotels looking for you. Please don't mention that thing I told you, she says. You know exactly what she means, a story so personal and revealing that she preceded it with the words Don't use this in your story. You try to convince her that it would be the perfect humanizing detail. I was up all night worrying about it, she says. I would never forgive myself if anything happened.

The abortionist's wife likes good coffee. So you meet at an espresso bar where the menu is in Italian.

She has a strong Roman nose and black hair that breaks against her cheeks in an ebony wave. Her earrings are shaped like dolphin tails. In a charming mixture of English and Spanish, she tells you about growing up in Cuba, happy sun-filled days and good medical training until she started ducking the weekly "discussion" meetings and they told her she wasn't a good communist. But when she finally managed to leave, she saw the other side. For example, when I going to Argentina, I have intrauterine device for anti-conception. When the ginecólogo attend to me, "You need take off this! This makes an abortion!"

Later, working in a hospital, she saw women who tried to induce their own miscarriages bleed to death.

Then she got pregnant. At eighteen weeks, she went to her gynecologist for the blood test. They say, The baby's no good. Have really problem. She went to a geneticist and a specialist in prenatal diagnosis. The geneticist suggested an abortion, butthe prenatal diagnoser, for one hour he was making the sonogram high-resolution. When he finish, he say, What do you think about the baby? And I say, I think he is good. I feel it in my soul, and I want to take him. He say, Go and take your baby.

Labor lasted thirty-six hours, intensive care a month. The specialists told her the baby might have lifelong seizures or learning disabilities. To lighten her workload, she moved to Barcelona and took a job in an abortion clinic. She sees no contradiction in this. Because I am happy in my pregnancy and I have a beautiful relationship with my belly. For many reasons, I believe in God and my fate. It's true in myself. But I know that many women don't feel nothing when they're pregnant and many women feel sad, feel angry. In this situation, you never can judge who's God. You need to respect women.

All that led to the man who would become her husband. She was at a medical conference in 2003 when he came up to her and said, You are so beautiful. He was sixty-four, she was thirty-seven. She was struck by his confidence. I say, This man is really seguro de sí mismo — sure of himself. I say, I like this man.

On the last night, he went to his knees and begged her to dance. Stand up, she said. Stand up! But she felt good dancing with him.

They began to send letters across the ocean and talk for hours on the phone. He was not one of these men who was just para enamorarla. He tried to know her, the woman and the professional and the mother. And he always showed to her his miedos, his fears and loneliness, especially the long grim years when he thought no woman could tolerate a life under siege by fanatics. She could relate. When I was aborting in Spain, I finished the abortion to a young woman, first trimester. When I finish this procedure, she sit on the table, see me to my face, say, Oh, doctor, you are really nice, you are such angel, how do you kill babies? I say, I'm sorry, I don't kill any baby. I aspirate gestational sac. You kill your baby.

But most important, he always asked about her son. Other men did not do that.

In March, he flew to Palma de Mallorca and they spent three beautiful days together.

In May, she noticed that her son had no grip in his left hand. She took him to the hospital and they discovered a brain tumor — a big one, nearly four centimeters.

Warren started calling her every day, sometimes twice a day. The hospital suggested high doses of chemotherapy, her doctor disagreed, Warren said to send him the MRIs. He doesn't rest one second. He find find find information. She decided to try surgery. She told Warren not to come and moved into the hospital to focus on her son. One by one, her other friends stopped calling. Warren called three times a day.

At Christmas, she took her son to Boulder and Warren introduced him to Santa Claus. I think I totally fall in love with him.

Warren is the most passionate man she has ever known, apasionado about everything he does. He is the kind of people that he going up to the mountain and he see the beautiful sunset, he sit down, he don't want to speak, and he cry.

In the summer of 2006, they were married.

But that was not their happy ending. At the end of May, when they were just back from a rafting trip in Utah, the wet clothes in a pile on the stairs, the phone rang. Warren took the call in his office. I start to take the breakfast in and he don't have color in his face. I say what happen? He say, A shooter shoot George Tiller. I think it's crazy people, and he say, No Amor, these people killed him. But why? You know why. I go to close the window but he no move, he no speak. I say, Do you need my help? He say, No. I need a little time.

When the shock passed, he called CNN. All day long the phones kept ringing. I kept say, He's on the other line. He cannot speak with you now.

The abortionist barely has time to eat. Reporters come and go, the phone rings constantly, he disappears to the hidden rooms where no outsider is allowed to go. Every so often he snatches a minute or two to drop into the counseling room. I want to talk to you about this dustup with National Abortion Federation, he says. They're not going to like to see this dirty laundry, but you know, this was a witch hunt. Just hideous attacks on my character. And I think that it's frankly far more painful to me than the fucking antiabortion people.

He suggests you read a paper he wrote, "Administrative Incongruence and Authority Conflict in Four Abortion Clinics." But he doesn't have time to say why. I have a lot of stuff to do. You're welcome to hang out.

You squeeze in another question. This idea about mankind being a "malignant ecotumor." Doesn't it just invite the hate?

I'm not inviting people to do anything. I'd like them to think. What a concept.

But still.

I do think that helping people control their fertility is highly consistent with helping people be responsible citizens of the planet. If somebody misunderstands it or tries to distort it, I don't give a shit. I'm sorry, I'm living in this country because I can say what I think.

But you're seventy. You have ideas for a dozen books. Why not retire?

I have work to do here. I have important work to do here.

You wanted to cozy up to the next question but there's no time, so you just blurt it out: What are your limits? When would you tell a woman no?

There's no specific answer to that. I'm in the process of turning down somebody who's going to be thirty-four, thirty-five weeks, with an important reason for doing abortion. I'm not going to do it.

The phone rings. Okay. I'll be right there, and he's gone.

Hours pass. You've been moved to the nurses' office, where a soft felt sunflower weaves through the metal in-box. On the wall, a poster of female reproductive organs looks vaguely like the mother alien from Aliens. You are staring at a flyer advertising the clinic's services: "Specializing in late abortion for fetal disorders. Outpatient abortion over twenty-six menstrual weeks for selected patients with documented fetal anomaly, fetal demise, or medical indications."

The opponents of legal abortion often use the phrase "abortion on demand," implying there are no restrictions at all. This characterization is untrue. It has always been illegal, even under Roe v. Wade, to perform abortions after viability without a compelling medical reason. In Kansas, for example, where Dr. Tiller practiced medicine, the law for any abortion after twenty-two weeks requires two doctors to agree that failure to abort would put the mother at risk of "substantial and irreversible harm." But the abortionist's long list of fetal abnormalities that have led women to his clinic ranges from anencephaly to dwarfism, and you know a few dwarfs. You like to think you'd be happy with a dwarf child.

The abortionist comes in, remembers that the U. S. marshals don't like him to use this room because the window is too exposed, and walks right back out. You follow, asking about the patients who were supposed to see Dr. Tiller.

The patient I just finished was very unhappy to see me. I think they are very antiabortion. She had a fetal abnormality, and she and her husband are just devastated. Stuff like that.

What kind of fetal abnormalities are we talking about?

One was Down syndrome, another was a lethal brain abnormality along with a lethal heart abnormality. Another one had a catastrophic — we're not talking about cleft lip, we are talking about cleft face. There was no face.

Is there any chance of interviewing some of them?

Absolutely not.

The abortionist goes home, riding in the bulletproof car with three U. S. marshals. You follow in a separate car. Another set of marshals checks your credentials before they let you in. Inside there's a beautiful Bösendorfer piano with Beethoven on the stand and a primitive bow and arrow from the Amazon rain forest, where the abortionist has traveled to cure diseases and conduct ethnographic studies for more than forty years. There are books everywhere, and many of the nature photographs he has published in environmental books and magazines. Then he leads you to his office. This is the descent into hell. I haven't had a chance to clean this up.

It's an understatement. There's a narrow path between the books and papers. The stacks rise like the houses in Horton Hears a Who! You walk around reading titles: Organization of Insect Societies. Sister Carrie. The Black Death. Cleansing the Fatherland. Abortion and Medical Ethics. Eve's Herbs. The Complete Idiot's Guide to MBA Basics. There's a book on clutter control, which is obviously not doing much good. Even the bathroom is stuffed with boxes.

Don't go in there. It's pretty bad.

He sits down to bang out a letter to President Obama. As you know, Dr. Tiller was unarmed, vulnerable, and acting as an usher for his fellow worshippers. It's four in the afternoon and he still hasn't eaten his miserable microwave tamales. You can't help wondering if he's the abstemious type who doesn't take pleasure in simple things like food.

I enjoy food when I have a chance. I love to cook. Grown men lie down on the floor and cry with ecstasy over my paella.

What do the women do?

They watch the men.

In three days, it's the first light thing you've heard him say. So you take the opportunity to try to reach the emotional core everyone keeps telling you about. This woman you refused to treat, what was her reason?

She was raped. I'm very sympathetic, but I can't risk my medical license for someone who just didn't get around to doing anything about it. I've done some cases over thirty-six weeks, but very few.

For what cause?

For some catastrophic problems.

Like what?

Oh, anencephaly or lack of kidneys, you know. Lack of a brain.

The antiabortionists say that in those cases, the woman should just give birth naturally and let God take the baby.

The sharp tone comes back. Having a delivery is not a benign procedure. When you are trying to keep the baby alive, that increases the risk for the woman. And Reagan put in a bunch of rules about requiring to keep babies alive no matter how hopeless it is. You have people going to Europe to get away from that.

You mean the hospital requires them to save the baby?

The hospital requires full resuscitation measures, no matter what.

Also, his seaweed procedure is very slow and gentle on the cervix. The tissue dehydrates, the collagen starts to pull apart, the uterus gets softer. If you do a forceful dilation, you're going to tear the cervix. All around, his way is safer.

Safer for the mom?

Not for the mom, he snaps, for the woman. Till she's had a baby, she's not a mom.

While you wait, you try to chat up his staff. Most don't want to talk on the record, but Amanda says she's been working here for thirteen years.The abortionist is very caring with all of them, she says. Like all doctors, he wants things done exactly his way. But he doesn't tolerate them being treated poorly. He pays them well. He gives them insurance and 401(k)'s, which is not routine in the abortion trade. Once, he took them all rafting down the Green River. That was delightful. He didn't care where anything was laid out in the camp.

The pens in the counseling room are always diagonal to the pad of paper, you've noticed.

He'll move them, too. As he talks to you, he'll move them.

So what brings out his emotions?

Well, I think it is really difficult for him when women are experiencing pain and he's not able to control that for them. That really affects him.

The abortionist is on the phone, talking with the editor of a scientific journal. Well, I went to George's funeral in Wichita, and I was probably the most heavily protected son of a bitch in the state. I was surrounded by rings of marshals and they might've been able to get me with a shoulder-mounted rocket or something. But the grief of this situation was pretty hard.

He hangs up and dials another number. Well, it's been a very tough week. You know, I liked the world a lot better the way it was a week ago Sunday morning — with George in it.

Back on the other line, he tells a reporter that he's just staggered by what happened last week and grieving the loss of a wonderful friend and an excellent doctor. Then a graphic designer comes in to chat about his latest book, an elaborate collage of photographs, stories, and poems:

I have resigned myself to temporary complicity with evil in order to accomplish certain strategic things for people whose suffering is more important than my need to maintain moral purity

The poem is about his work in the Nixon administration, he says.

The phone rings again. This time it's the president of the National Society of Genetic Counselors, Steven Keiles. The abortionist wants him to issue a statement denouncing the murder, the sooner the better. I'm sorry, this is not very complicated. You make a statement and you issue it to the press, a one-page statement condemning the brutal assassination of a conscientious and dedicated doctor who helped tens of thousands of women. As far as I'm concerned, it should have been issued last Monday. I don't know why you have to go through a PR firm. I'm sorry, but it just seems very, very bureaucratic to me. I know that abortion is controversial among the members, but I think that the statement by the NSGC would be very important. He slamsdown the receiver. That guy is a fucking clerk.

I have no patience for this kind of bullshit. George gave them so much money and so much help.

Encouraged by the designer, he starts ranting about the time the militant antiabortion activist Randall Terry prayed for his death on national Christian radio. These guys are just despicable. If anyone wants hope for the human species, don't talk to me.

A receptionist comes to close the door so the patients don't hear him.

In passing, the abortionist says you can never get used to this. Next time he gives you a minute, you ask him to elaborate.

You can't, he says. I think we're hardwired, biologically, to protect small, vulnerable creatures, especially babies. The fetuses may not be babies, but some of them are pretty close.

Since you've become wary of even saying the word baby around him, always using fetus instead, this surprises you. But he refuses to say any more. He suggests you read an essay called "What About Us? Staff Reactions to D&E." The antiabortion people quote the shit out of it. It's kind of antiabortion porn for them. But the pro-choice people don't like it either. They don't like it when you talk about how it really feels to do this work. His voice is somewhere between bitter and proud.

So why did he write it? For that matter, why does he write so many papers and books? And why does he escape to the jungles of Peru every chance he gets? And what about this theory that man is a cancer? Is it all some kind of elaborate coping mechanism that makes it easier for him to do what he does?

I wrote it because, A, I'm a human being, and B, I'm a writer, and C and D, I'm a physician and I'm trying to understand what we're doing here.

You read the paper. He describes the reactions members of his staff have when they see residue of late abortions, which include shock, dismay, amazement, disgust, fear, and sadness. The later the pregnancy, the harder it is to accept. One assistant resented the patients for putting them through such a horrible experience. Two others described dreams where they vomited fetuses or felt an overwhelming urge to protect others from viewing the fetal parts. Common coping mechanisms were denial, projection, and rationalization. For the senior author, rationalization has been shown by his intensive involvement in professional meetings, where this matter is discussed, and by his seeking peer support from colleagues who have similar experiences.Another great help was the relationships with the patients, which helped the senior author maintain his sense of commitment. It ended with the passage the antiabortionists love to quote, always out of context, words so honest they are almost as painful to read as they must have been to write:

We have reached a point in this particular technology where there is no possibility of denying an act of destruction. It is before one's eyes. The sensations of dismemberment flow through the forceps like an electric current. It is the crucible of a raging controversy, the confrontation of a modern existential dilemma. The more we seem to solve the problem, the more intractable it becomes.

The abortionist is in the basement doing an abortion. Today is Thursday, operating day. He said you couldn't be here but he called at 7:30 A.M. and said he changed his mind. Now it's just after 8:00. It's very quiet. The waiting room is empty. So are the examining rooms. A receptionist tells you he just got done with a patient and should get back shortly.

The phone keeps ringing. If you have tissue samples, says the receptionist you cannot name, that makes it logistically easier. Can I put you on hold one second?

She opens the door for the sad woman and her daughter. Thank you, the daughter says in an emphatic tone that suggests she's not just talking about the door.

A few minutes pass and the phone rings again. Good morning, Dr. Hern's office. Okay, did you get any measurements from the ultrasound? Okay. And where was this done? Okay.

Another line rings. Could you hold for a second? Good morning, Dr. Hern's office. Okay, I can make an appointment. Can I have your last name and date of birth? Can you hold for a second?

When the calls slow down, the receptionist tells you about the time a pro-life reporter pretended to be looking for information and then quoted her by name. They do these things to scare you. They like to let you know they know where you live.

The U. S. marshals keep walking up and down the hall, carrying black bags that look ominously tactical.

The abortionist comes upstairs and moves you to the nurses' office so he can do an interview with a reporter from The Wichita Eagle. Her husband was in the church when Tiller got killed. They're just getting started when he jumps up. I'm sorry, I have to go see a patient.

The receptionist you cannot name is on the phone again. Is someone reading the results for you? Is there someone who can interpret them for you?

The other receptionist lets a man in the door. Thanks for being here, she says. You'll wait downstairs.

The abortionist comes back to the reporter from Wichita. The antiabortion movement is the face of fascism, he says. It cannot be separated from the ruthless and cynical manipulation of antiabortion rhetoric by the Republican party.

The receptionist opens the door again. It's a woman in an ankle-length Amish dress. You've seen her before. She's usually with another woman in the same kind of dress. She's waiting downstairs, the receptionist says, hitting a button that rings an internal line. Dr. Hern? Can you tell B — — her mother is coming down to be with her?

While you wait, you read another one of the abortionist's essays.It has been my practice to rupture membranes with ring forceps, it says.

Another man comes to the door. I'll tell her you're on your way down, the receptionist says.

The phone rings. Dr. Hern's office. I can check for you. He's with a patient. Are you sure you don't want me to take a phone number?

The phone rings again. Dr. Hern's office.

At 11:30, the abortionist comes up in a cheerful mood. I have to go check the level of molecular degeneration in my tamales.

It's the second lighthearted thing you've heard him say this week. And when he comes back from the kitchen, he says another. I identified a new species in my tamales. But I think with a gastroenterologist standing by...

The receptionist smiles. It's your risk.

The two Amish women leave. The abortionist walks them to the door. Have a safe trip home, he says. Give my regards to Dr. H — .

In the counseling room, which the marshals have judged safe, he sits down with a weary sigh and picks up the phone. Amor, he says.

In the nurses' office, the soft felt sunflower weaves through the metal in-box. The poster that looks like the mother alien glares down at you. From the room next door, the abortionist's voice rises so high you can hear it through the wall. I'm sorry, I'm sorry, I can't meet with every person who wants to talk to me.

He stops in to say hello, forgetting the rule about not using this room for a moment. I have to go downstairs and finish seeing a patient, he says.

The phone rings. June 24 is the first time we are seeing patients. At that time, based on the information you gave me, the fee will be $7,500.

A young woman wearing a 1920s flapper scarf that Isadora Duncan might have worn comes up the stairs alone. At that very moment, you are reading page 83 of Abortion Practice, the section called Isolation: One of the loneliest persons in the world is the woman who has not told anyone she is pregnant or considering an abortion. Some women have no one to whom they can turn; others insist on suffering alone as a form of self-punishment. The individual abortion counselor may, and frequently does, fill that gap for both kinds of patients.

The woman in the flapper scarf stops at the receptionist's office. Thank you so much, she says. You're so helpful. You're wonderful ladies.

Another woman stops at the desk. She's a Latina with short black hair, here for her sister. Can I wait? I want to say goodbye to everyone.

The phone rings. Who referred you to our office? And they did the ultrasound? Can you call them and have them send it to us? Do you have a pencil handy? You have a whole week. Don't give up.

The phone rings. Well, have you had an ultrasound? Okay. If it's between nineteen weeks and twenty-four weeks, it'll be between $5,000 and $7,500.

Five minutes later, it rings again. No, we need to know what the measurements are before you travel all the way to Colorado. It's a measurement in millimeters and centimeters. Fax it to us. Everything is based on the measurement.

Three minutes later, it rings again. Dr. Hern's office.

Four minutes later, it rings again. Dr. Hern's office.

At 1:35, the sad woman emerges from the basement with her daughter, who is very tall for fifteen. The sad woman goes out the bulletproof doors and the daughter sits down in the waiting room. The receptionist goes out to check on her. Are you waiting for your mom?

She answers in a soft and girlish voice that makes you think of the army of Beanie Babies in your daughter's closet. Yeah, she's coming.

You'll get a good night's sleep tonight. Tomorrow, drink a lot of fluids and get rest.

At 1:43, the phone rings. Dr. Hern's office.

Now it's 1:47, and you're sitting down in the counseling room with the young couple who arrived in Wichita just in time to see the news cameras that surrounded the Reformation Lutheran Church. The woman has light-brown hair and wears conservative glasses. She is calm, somber, and depleted. Her husband sits in the opposite chair watching her carefully. He says he does not want her to talk for too long. She's feeling weak.

As gently as you can, you ask her to tell you why she chose abortion.

We had found out that something was wrong at twenty-eight weeks, seriously wrong. And they found out that it was going to put me, my health, perhaps in danger if I carried through to the end of the pregnancy.

We were caught between grieving about going through this and this awful situation.

And then what did you do?

I was scared to stay so close to where something like this could happen. We went home right away.

She corrects herself. Well, we tried to call here to see if we could fly here, but they were already overbooked and obviously the whole emotional thing, so they recommended that we wait a week.

And you couldn't find any other doctor close to home?

They do these kinds of procedures in Canada, where we come from, but because I was a very complicated case, and because I didn't feel comfortable with the way they wanted to do it, it was very high risk, and I wanted to come to someone who really knows and is an expert at this.

Do you mind explaining why it was so complicated?

Because of the abnormalities of the child. It was giving me health complications.

What was wrong?

It was severe abnormalities.

You change the subject, asking what was wrong with the Canadian doctors.

They do it very fast. They don't use the seaweed, they don't take their time, and it puts the woman at risk. And you're at risk of losing your uterus. I would like to have children, so I didn't want to have that risk.

And how did it go, the surgery?

Well Dr. Tiller said that —

Hern.

Oh, sorry, sorry, sorry. Dr. Hern said that I was a very complicated case. He said it went well, but it wasn't an easy thing to do.

Was it painful?

Yeah, it was painful physically and mentally.

You don't want to push it. So you ask if there's anything else they want to say. The husband answers.

It's important that people have a choice. At the end of the day, when things go bad, you know? I mean, God forbid something happens to Dr. Hern, where are we going to go next? Australia? China? It's important that people know that choice is very important when it comes to things like this.

Five minutes later, you catch the abortionist in the nurses' office, where the U. S. marshals don't want him to go, and ask him to tell you what was wrong with the couple's baby — excuse me, fetus. You're pretty sure it was the one with the lethal brain and lethal heart. But he won't say. So you ask him how it went.

It was very difficult.

Did it take a long time?

Yeah, it was a long time. Very long procedure.

How long is long?

Forty-five minutes. The average procedure is five minutes.

What was the problem?

Well, she was very far along. It was the position of the uterus, and she had a previous C-section, poor dilation, it was very difficult. I think any other procedure would have been very, very dangerous for her.

She was in danger of her life?

Oh yeah. She would have risked having a ruptured uterus in an induction procedure.

In surgery, or in birth?

Well, she's at risk, at this point, no matter what she decides to do. That's why I'm quite sure this was the safest option for her. No doubt about it.

The abortionist gives you directions to the Temple Emanuel in Denver. Later that evening, you will drive down with his wife and son, chatting about life under communism and brain surgery from the patient's point of view. You'll have a copy of the abortionist's speech, which he stayed up till 1:00 A.M. writing, but when he ascends to the dais, for reasons you feel more than understand, you will turn on your recorder anyway. He'll start to choke up when he says that Tiller was gentle, considerate, and compassionate, then recover and roll into the refuge of his annealing anger: This brutal, cold-blooded, premeditated political assassination is the inevitable and predictable result of over thirty-five years of rabid antiabortion harassment, hate rhetoric, violence...

When he comes off the stage to embrace the wife you cannot name, he will break down in racking sobs. The son you cannot name will stroke his shoulder. You will be standing right next to them, close enough to hear him say, Amor, Amor, Amor, close enough to hear members of the audience — who came by word of mouth, because the rabbi considered it too dangerous to advertise publicly — whisper their gratitude. Thank you for your courage. Thank you for your commitment. One woman squeezes his hand between hers. It's because of people like you that my relatives survived the 1940s.

But this comes later. Right now, it's 2:27 and the receptionist you cannot name is talking on the phone again. No, he can't do it tonight. The soonest we can schedule it is the twenty-third.

She cups her hand over the receiver. This woman wants to come tonight — to fly in.

Absolutely not, the abortionist says. I absolutely can't do it.

The receptionist takes her hand off the phone. He can't do it until the twenty-third. He can't see you tonight.

She pauses to listen. He's trying to live his life as well, she says. The best we can do is the twenty-third.

She pauses again. I would say check with the doctor who referred you. Do you want to take a deep breath? Take a deep breath and call me back.

Another pause, then the receptionist continues. He can't change his mind. This is beyond his control. All you need to know is he can see you on the twenty-third. You need to plan a plane trip to Colorado on the twenty-second. Talk to your husband for a minute and call me back. My name is — But you cannot say her name.

Three weeks later, the woman from Canada calls you on the phone. She says she has some things she wants to tell you. It was the most tragic and terrible experience of my life, she begins, speaking with force, the words rushing out. She has a son almost ready to start kindergarten, she was afraid she wouldn't survive to raise him, and she wants to have a big family, with lots of children, and the situation was so crazy with the marshals and the bulletproof glass and the constant fear of a mad killer with a gun. Dr. Hern was under so much pressure. She could see the stress in his face. I didn't have a chance to tell you all this because after the procedure I just wanted to curl up in a ball, and I didn't know how I felt back then, to be honest. Now I'm still recovering and still sad and still mourning, and I realize how grateful I am that Dr. Hern was able to take me under such quick and terrible circumstances. That's what gets me so upset. He's a doctor who is trying to help people — it's shocking that people would want to hurt him.

Without Dr. Hern, she says, she doesn't know what she would have done. It's crazy that he's the only one left. She is grateful, grateful, so grateful that she will be here to raise her son. And as the words tumble and repeat you hear, in the urgency unleashed by her deliverance, a love too sad for sermons, too personal for headlines, a private benediction, the abortionist's reward, the love song of Warren Martin Hern, M.D.